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PBC - Specification - Coggle Diagram
PBC - Specification
Specification
Presentation
Epidemiology
Symptoms
*chronic fatigue – this is a common symptom (but not always caused by PBC) presented at diagnosis
*pruritus – this may diminish as the disease progresses
joint pains
right upper quadrant pain or discomfort
recurrent UTIs
hyperpigmentation
Physical Examination?
• hepatomegaly and splenomegaly
• hyperpigmentation
• jaundice of cholestatic disease with dark urine and pale stools as disease progresses
• sicca syndrome: dry eyes and mouth
• xanthelasma (in later stages of disease)
Associated Conditions?
• cholelithiasis
• thyroid disease
• systemic sclerosis
• coeliac disease
• Sjögren's syndrome
• anaemia with an immune/autoimmune aetiology
• osteoporosis
• hyperlipidaemia
Diagnosis of PBC
Liver biochemistry
• Alkaline phosphatase (ALP) levels exist
• Gamma-glutamyltransferase (GGT) exist
Autoantibodies
• PBC-specific autoantibodies (anti-mitochondrial antibody (AMAs) exist
• PBC-specific anti-nuclear antibodies (ANAs) exist
Imaging
Biopsy
Treatment (Medications)
Ursodeoxycholic acid (UDCA)
Obeticholic acid
Stages/Pathway
Initial treatment
Chronic disease management
Pre-diagnosis
Diagnosed - PBC
Symptoms
e.g. Chronic Fatigue, Pruritus, Joint Pains
Monitoring
Treatment
1st, 2nd Line